Majority
of sites contained information content congruent with published
smoking cessation guidelines. 93.3% of sites written above
a fifth-grade Flesch-Kincaid reading level; 9 sites contained
>50 pages of content; 16 had site map or search mechanism;
63.3% were created by organizations with authors having
health credentials; 3 sites supported claims with reference
to scientific research; 5 sites displayed when their content
was last updated.

37
public Web sites on health behavior change for disease
prevention and management

273
Web sites addressing 7 targeted problem areas (tobacco
use, physical activity, alcohol, diet, diabetes, depression,
and pediatric asthma) were identified and screened according
to quality criteria that would determine whether the sites
had the minimum criteria for having the potential to change
behavior. 15% (42) of the programs met 4 of 5 of the criteria,
and these sites underwent a full review.

Found
that the types of assessments varied across types of programs;
81% of programs gave a rationale for the assessment; 84%
of the programs provided feedback that followed appropriately
from the assessment, although only five used individualized,
tailored feedback; 73% offered some form of anticipatory
guidance to prevent relapse; 11% specified when a user
should come back, and 22% used e-mail reminders to keep
in contact; 29% explicitly stated use of a theoretical
model; 78% were part of a site addressing multiple risk
behaviors. Interactive features included assessments (100%),
chat room (49%), bulletin boards or discussion lists (73%),
ask-the-expert (49%), behavior tracking tool (49%), e-mail
reminders or newsletters (70%). 76% required registration
with a password to access all of site. 92% posted a privacy
policy statement. 100% had some form of contact, either
e-mail or phone. None of the sites included information
about evaluation for effectiveness.

85.
Fahey D, Weinberg J.
LASIK complications and the Internet: is the public being
misled? Journal of Medical Internet Research 2003;5:e2.
[Appropriateness]

17/21
sites were commercial; 5/21 (24%) had no information on
complications. Of the 16 sites that had information on
complications: the author of the information was clearly
identified in 5 (31%), the content was referenced in 2
(12.5%), and evidence of the information having been updated
was seen in 2 (12.5%).

86.
Finn J. An exploration
of helping processes in an online self-help group focusing
on issues of disability. Health and Social Work 1999;24:220-31.
[Acceptability]

NA

Social
support: lab computer with Internet

An
online group whose purpose was to allow discussion and
support between individuals coping with physical or mental
limitations

Analyzed
3 months of messages from an online support group

Types
of posts

Messages
focused on health and disability-related information (38.2%
of posts), emotional and interpersonal issues related to
disability (28.4%), empowerment of members through legal
and political means (11.2%), plus more than 1/10 messages
devoted to social interchange unrelated to issues of health
or disability.

Evaluation
of 119 Internet sites found via 6 search engines and 2
metasearch engines. The first 20 “hits” for
each separate search engine were included in the study.

Educational
information on laparoscopic obesity surgery, discussion
of at least one procedure related to the surgery, procedure
details, discussion of other procedures, discussion of
risks, including death, and discussion of this surgery
as an option for obesity surgery. Sites were also evaluated
for inclusion of misleading or biased information.

A
total of 602 hits found with search engines. Of these,
only 119 unique sites. Of these, 63/119 had educational
information about bariatric surgery, 56 discussed laparoscopic
surgery as an option, 33 gave details of the procedure,
30 discussed accurate weight loss results, 26 discussed
death as a complication, 18 contained biased or misleading
information. Only 89 of the original 602 hits led to sites
that discussed this type of surgery, procedure details,
and complications in an unbiased manner.

113
women who received the Comprehensive Health Enhancement
Support System (CHESS) and who had participated in the
discussion group; 86 white, 23 African American, 2 Native
American, 2 Asian

Cancer:
lab computer with Internet

CHESS
breast cancer module: study focused on use of the Women’s
Only Discussion Group, which only allowed access to women
with breast cancer.

Messages
from the discussion group were randomly selected for analysis.

Use
of discussion group, message content

Women
of color used the discussion group significantly less than
Caucasian women. Most of their use was in the first 3 months,
while the Caucasian women’s use of the discussion
group declined much more gradually. Women of color wrote
a greater proportion of messages specific to breast cancer
and its treatment, and fewer dealing with daily life than
Caucasian women. The groups did not differ in self-disclosure,
but Caucasian women were more likely to offer support to
other women. Message focus changed over time. Caucasian
women wrote more about daily life than breast cancer as
time went on. Women of color initially wrote more about
breast cancer, and then overall usage dropped off significantly.

Researchers
developed a tool, based on the American Diabetes Association’s
Clinical Practice Recommendations, that would allow evaluation
of the quality of diabetes-related Web sites. Then they
assessed 90 diabetes-related Web sites using the tool.

Quality

Found
wide variation in the quality of consumer diabetes information
on the Internet. Average score of 50% suggests substantial
level of inaccurate and missing information.